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Published: April 7, 2021

Pelvic Floor Physiotherapy: What is it and Who Can We Help?

By: Ellen Rossiter, PT

Pelvic floor physiotherapy is slowly becoming a more well-known option in the rehabilitation world, but what exactly is it?

Let’s start with the basics. The pelvic floor is the group of muscles and surrounding tissue at the bottom of the pelvis. It has many functions, the main ones being continence, support of organs, and sexual function. Everyone with a pelvis has a pelvic floor, they just look a little bit different based on that person’s sexual organs.

The pelvic floor, like any other muscle group, can become tight or weak based on activities, injuries or trauma, and day to day functions. This especially includes people who have carried children, as the pelvis changes to support the child in the womb, and those who have experienced childbirth, whether vaginal or caesarean. Tightness and weakness in the pelvic floor, or direct trauma to the pelvic tissues can then cause urinary or bowel incontinence, urinary urgency, pelvic organ prolapse, pelvic pain and sexual pain and dysfunction. What is interesting, and lesser known, is that pelvic floor dysfunction can also manifest as hip and back pain.

Can it help even if I had kids, an injury, or a surgery 25 years ago?

Yes! It does not matter how long ago the issues started, there can usually be some benefit to working through a pelvic floor program. Many people suffer with symptoms for most of their lives thinking that it is too late to make changes, but that is generally not the case.

So what does a pelvic floor physiotherapist actually do?

Pelvic floor physiotherapists are able to assess both internally and externally to find out what tissue is actually causing the problem, whatever the problem may be. This may include a detailed discussion of experiences, assessment of the back and hips and other related muscles and joints, and an internal exam of the deep muscles and tissue that cannot be felt on the outside. This internal exam would be completed vaginally and/or rectally. Although general recommendations can be made without an internal exam, this exam is important to really understand what muscles or tissues are related to the specific issues, and what the appropriate course of action may be.

Once the assessment is complete, a plan can be made. The plan may include lifestyle modifications, exercises, stretches, dietary changes - the options are endless! This is also why a thorough assessment is necessary. If we don’t understand the root cause, it is hard to tailor a proper plan to meet the patient’s specific needs. One example of this is the common prescription of kegels to anyone who is incontinent; kegels can be good for someone with a weak pelvic floor, but can actually be detrimental if they have a tight pelvic floor!

But isn’t an internal exam awkward?

To be honest, yes it can be. The pelvis is a sensitive area for many reasons, and everyone has a different experience when it comes to that area. Everyone who performs an internal exam has had extensive exams completed themselves, so we have experienced the process. For this reason, I will always recommend wearing something comfortable, possibly bringing a cozy robe if you would like, and we will always move through the exam slowly. It is YOUR body, so YOU are completely in charge!

Key Points:

• Everyone has a pelvic floor, and it can be affected by activities, injuries, trauma, pregnancy and birth, surgeries, and much more.
• Pelvic floor PT includes thorough discussion, internal and external assessment, and a specific plan including manual work (possibly internal), a home program (including stretches and exercises) and lifestyle changes.
• Pelvic floor physiotherapy can help with: incontinence, urgency, prolapse, pain (pelvic, back, hips, etc), and sexual pain and function.
• It may be a sensitive area, but YOU are in total control of the entire assessment and treatment process.

If you think that pelvic floor physiotherapy could be of assistance to you, please book an appointment with our Pelvic Floor Physiotherapist Ellen Rossiter, PT. Find our contact page here.

*This blog is not intended to officially establish a physician-patient relationship, to replace the services of a trained physician, naturopathic doctor, physical therapist or chiropractor or otherwise to be a substitute for professional medical advice, diagnosis, or treatment.

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